Autotransplantation for relapsed or refractory non-Hodgkin's lymphoma (NHL): Long-term follow-up and analysis of prognostic factors

A. P. Rapoport*, R. Lifton, L. S. Constine, R. E. Duerst, C. N. Abboud, J. L. Liesveld, C. H. Packman, S. Eberly, R. F. Raubertas, B. A. Martin, W. R. Flesher, P. A. Kouides, J. F. Dipersio, J. M. Rowe

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

50 Scopus citations

Abstract

One hundred and thirty-six patients autografted for relapsed or refractory non-Hodgkin's lymphoma (NHL) were evaluated to assess long-term event-free survival and to identify important prognostic factors. High-dose therapy consisted primarily of carmustine (BCNU), etoposide, cytarabine, and cyclophosphamide (BEAC) followed by unpurged autologous stem cell rescue. The 5-year Kaplan-Meier event-free survival (EFS) for the entire cohort was 34% (95% confidence interval: 24-44%) with a median follow-up of approximately 3 years (range 0-7.5 years). For patients entering with minimal disease (defined as all areas ≤ 2 cm), the 5-year EFS was 40 vs 26% for those entering with bulky disease (P = 0.0004). In the multivariate analysis, minimal disease on entry and administration of involved-held XRT post-transplant were significantly associated with improved EFS; the latter association was observed mainly in the cohort of patients with bulky disease. The overall 100-day treatment-related mortality rate was 4.4% (3% for the last 71 patients). New strategies are needed to reduce the high rate of relapse (50-60%) following autotransplantation for relapsed or refractory NHL.

Original languageEnglish (US)
Pages (from-to)883-890
Number of pages8
JournalBone Marrow Transplantation
Volume19
Issue number9
DOIs
StatePublished - May 1 1997

Funding

This work was supported in part by a Fellowship from the James P Wilmot Foundation (APR) and presented in part at the Annual Meeting of the American Society for Clinical Oncology, Philadelphia, May 19, 1996. We thank Kim Altobelli, Lynn Sievert, Sharon Swift, Wendy Silverman, Lucy Wedow and the dedicated nurses of the Samuel E Durand Bone Marrow Transplant Unit for the excellent care of these patients. Carol Weed and Barbara McIntyre provided expert secretarial assistance. We also thank Dr Marshall Lichtman for critically reviewing this manuscript.

Keywords

  • Autotransplantation
  • Lymphoma
  • Prognostic factors
  • Radiotherapy

ASJC Scopus subject areas

  • Transplantation
  • Hematology

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